Effectiveness of social prescribing for chronic disease prevention in adults: a systematic review and meta-analysis of randomised controlled trials

Abstract

BackgroundSocial prescribing (SP) enables healthcare professionals to link patients with non-medical interventions available in the community to address underlying socioeconomic and behavioural determinants. We synthesised the evidence to understand the effectiveness of SP for chronic disease prevention.MethodsA systematic literature search was conducted using five databases and two registries. Eligible studies included randomised controlled trials of SP among community-dwelling adults recruited from primary care or community setting, investigating any chronic disease risk factors defined by the WHO (behavioural factors: smoking, physical inactivity, unhealthy diet and excessive alcohol consumption; metabolic factors: raised blood pressure, overweight/obesity, hyperlipidaemia and hyperglycaemia). Random effect meta-analyses were performed at two time points: completion of intervention and follow-up after trial.ResultsWe identified nine reports from eight trials totalling 4621 participants. All studies evaluated SP exercise interventions which were highly heterogeneous regarding the content, duration, frequency and length of follow-up. Majority of studies had some concerns for risk of bias. Meta-analysis revealed that SP likely increased physical activity (completion: mean difference (MD) 21 min/week, 95% CI 3 to 39, I2=0%; follow-up ≤12 months: MD 19 min/week, 95% CI 8 to 29, I2=0%). However, SP may not improve markers of adiposity, blood pressure, glucose and serum lipid. There were no eligible studies that primarily target unhealthy diet, smoking and excessive alcohol drinking behaviours.ConclusionsSP exercise interventions probably increased physical activity slightly; however, no benefits were observed for metabolic factors. Determining whether SP is effective in modifying the determinants of chronic diseases and promotes sustainable healthy behaviours is limited by the current evidence of quantification and uncertainty, warranting further rigorous studies.PROSPERO registration numberCRD42022346687.

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“…The evidence found could be used by policy makers and health care professionals to set appropriate guidelines and policies and to improve patient outcomes through nonmedical interventions, such as social prescribing. 152 Because SDoH are currently overlooked in predicting health outcomes, including CVD, 153 , 154 , 155 , 156 and because our review identified that SDoH factors have a role in CVD and CVD mortality, we recommend that future clinical CVD prediction models should include the SDoH.…”

Socioeconomic, Behavioural, and Social Health Correlates of Optimism and Pessimism in Older Men and Women: A Cross-Sectional Study

“…‘Social prescribing’ can be defined as a process that enables healthcare professionals to refer patients to a link worker to initiate a non-clinical social prescription to improve their health and well-being [ 66 , 67 ]. Social prescribing is being proposed as a solution to poor social health, as an innovative holistic community-centred approach [ 68 ]. There are systematic reviews demonstrating benefits of social prescribing to well-being [ 69 , 70 ] and quality of life [ 71 ].…”

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